US8346335B2 - Analyte sensor calibration management - Google Patents
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- US8346335B2 US8346335B2 US12/363,712 US36371209A US8346335B2 US 8346335 B2 US8346335 B2 US 8346335B2 US 36371209 A US36371209 A US 36371209A US 8346335 B2 US8346335 B2 US 8346335B2
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Classifications
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
- A61B5/1495—Calibrating or testing of in-vivo probes
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- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
- A61B5/14503—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue invasive, e.g. introduced into the body by a catheter or needle or using implanted sensors
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
- A61B5/14532—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue for measuring glucose, e.g. by tissue impedance measurement
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
- A61B5/1486—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using enzyme electrodes, e.g. with immobilised oxidase
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
- G16H40/40—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the management of medical equipment or devices, e.g. scheduling maintenance or upgrades
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2560/00—Constructional details of operational features of apparatus; Accessories for medical measuring apparatus
- A61B2560/02—Operational features
- A61B2560/0223—Operational features of calibration, e.g. protocols for calibrating sensors
Definitions
- a temperature detection section 203 of the data processing unit 102 is configured to monitor the temperature of the skin near the sensor insertion site. The temperature reading may be used to adjust the analyte readings obtained from the analog interface 201 . Also shown is a leak detection circuit 214 coupled to the guard trace (G) 211 and the processor 204 in the data processing unit 102 of the data monitoring and management system 100 . The leak detection circuit 214 may be configured to detect leakage current in the sensor 101 to determine whether the measured sensor data are corrupt or whether the measured data from the sensor 101 is accurate. Such detection may trigger a notification to the user.
- FIG. 5A shows a perspective view of an embodiment of an electrochemical analyte sensor 500 having a first portion (which in this embodiment may be characterized as a major portion) positionable above a surface of the skin 510 , and a second portion (which in this embodiment may be characterized as a minor portion) that includes an insertion tip 530 positionable below the skin, e.g., penetrating through the skin and into, e.g., the subcutaneous space 520 , in contact with the user's biofluid such as interstitial fluid.
- Contact portions of a working electrode 501 , a reference electrode 502 , and a counter electrode 503 are positioned on the portion of the sensor 500 situated above the skin surface 510 .
- a mass transport limiting layer is a membrane composed of crosslinked polymers containing heterocyclic nitrogen groups, such as polymers of polyvinylpyridine and polyvinylimidazole. Electrochemical sensors equipped with such membranes have considerable sensitivity and stability, and a large signal-to-noise ratio, in a variety of conditions.
- a sensor may be calibrated using only one sample of body fluid per calibration event. For example, a user using need only lance a body part one time to obtain sample for a calibration event (e.g., for a test strip), or may lance more than one time within a short period of time if an insufficient volume of sample is obtained firstly.
- Embodiments include obtaining and using multiple samples of body fluid for a given calibration event, where glucose values of each sample are substantially similar. Data obtained from a given calibration event may be used independently to calibrate or combined with data obtained from previous calibration events, e.g., averaged including weighted averaged, etc., to calibrate.
- An analyte system may include an optional alarm system that, e.g., based on information from a processor, warns the patient of a potentially detrimental condition of the analyte. For example, if glucose is the analyte, an alarm system may warn a user of conditions such as hypoglycemia and/or hyperglycemia and/or impending hypoglycemia, and/or impending hyperglycemia. An alarm system may be triggered when analyte levels reach or exceed a threshold value. An alarm system may also, or alternatively, be activated when the rate of change or acceleration of the rate of change in analyte level increase or decrease reaches or exceeds a threshold rate or acceleration.
- an alarm system may also, or alternatively, be activated when the rate of change or acceleration of the rate of change in analyte level increase or decrease reaches or exceeds a threshold rate or acceleration.
- the ESA detection component of the calibration management algorithm includes detection of the sensor signal (for example, the raw current signal from the analyte sensor) and evaluating it for characteristics of ESA condition. If ESA condition is detected based on this evaluation, a calibration of the analyte sensor is requested (for example, by prompting the user to perform a fingerstick measurement and enter the resulting reference blood glucose measurement value) to obtain a sensitivity used to confirm the ESA event.
- the sensor signal for example, the raw current signal from the analyte sensor
- a calibration of the analyte sensor is requested (for example, by prompting the user to perform a fingerstick measurement and enter the resulting reference blood glucose measurement value) to obtain a sensitivity used to confirm the ESA event.
- K lo — Rel — ESA — FS[2] is less than or equal to K lo — Rel — ESA — FS[1]
- K lo — Rel — ESA — FS — Cal[2] is less than or equal to K lo — Rel — ESA — FS — Cal[1]
- each of these parameters may be predetermined values (for example, set at 0.5 or 0.75 or other suitable value) programmed or programmable in the receiver unit 104 / 106 ( FIG. 1 ) of the analyte monitoring system, for example.
- the absolute test compares the sensitivity level S i (k) to sensitivity thresholds scaled to the analyte sensor nominal sensitivity S nom .
- S i (k) may be chosen such that it passes calibration post condition verifications.
- ESA_FS levels are assigned as follows:
- G CAL a predefined number of the most recent unfiltered glucose samples from the analyte sensor, G CAL , are averaged to derive at the glucose value G ESA — CGM .
- G min — ESA — CGM[2] is less than or equal to G min — ESA — CGM[1] , and further, correspond to predetermined values or parameters programmed into the system.
- the sensor signals may be further processed to determine stability and possible errors. For example, in one aspect, when a level 2 output (i.e., likely ESA condition) from the second signal detector occurs for the first time, an immediate request for a stability calibration may be generated. After the first occurrence of level 2 output from the second signal detector, the analyte sensor signals are checked at the time intervals (for example, approximately 1 to 2 hours, or other suitable time interval) since the last reference blood glucose measurement with stability verification routine before another measurement is requested, after the most recent successful calibration. Further, a nonzero level (i.e., a level 1 or level 2—possible or likely ESA condition) triggers a stability calibration request. Also, in one aspect, if a previous ESA_FS level is greater than 0, a reference blood glucose measurement is requested at a time interval since the last blood glucose measurement, and ESA_FS is determined using the new reference measurement.
- a level 2 output i.e., likely ESA condition
- the ESA detector determines whether a grace period of an existing reference blood glucose measurement request has expired ( 904 ). If it is determined that the grace period of the existing reference blood glucose measurement request has expired, then the display or reporting module associated with the output of the analyte sensor data is disabled, suspended, deactivated or otherwise blanked such that no real time glucose information is provided to the user ( 910 ). If it is determined however, that the grace period of the existing reference blood glucose measurement request has not expired, then the ESA categorization module output from the ESA categorization module ( 620 ) is retrieved ( 905 ).
- method, apparatus and system for providing effective analyte sensor calibration management is described that monitors the early attenuation of sensor signals and processes the monitored signals to maximize the sensor data yield by providing as much of the useful and accurate monitored glucose level information to the user.
- the software required to carry out the inventive process which may be stored in the memory or storage device (not shown) of the data processing unit 102 , receiver unit 104 / 106 or the data processing terminal/infusion section 105 , may be developed by a person of ordinary skill in the art and may include one or more computer program products.
- the signal from the analyte sensor may be associated with a monitored analyte level.
- the reference data may include an in vitro blood glucose measurement data.
- An apparatus in accordance with still another aspect may include a data communication interface, one or more processors operatively coupled to the data communication interface, and a memory for storing instructions which, when executed by the one or more processors, causes the one or more processors to position an analyte sensor in fluid contact with an analyte, detect an attenuation in a signal from an analyte sensor after positioning during a predetermined time period, categorize the detected attenuation in the analyte sensor signal based, at least in part, on one or more characteristics of the signal, and perform signal processing to generate a reportable data associated with the detected analyte sensor signal during the predetermined time period.
- the memory for storing instructions which, when executed by the one or more processors, may cause the one or more processors to disable the outputting of the data associated with the monitored analyte level after the preset time period has elapsed.
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- Primary Health Care (AREA)
- Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
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Cited By (28)
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US20060189863A1 (en) * | 1998-04-30 | 2006-08-24 | Abbott Diabetes Care, Inc. | Analyte monitoring device and methods of use |
US20090247855A1 (en) * | 2008-03-28 | 2009-10-01 | Dexcom, Inc. | Polymer membranes for continuous analyte sensors |
US20100094110A1 (en) * | 1998-04-30 | 2010-04-15 | Abbott Diabetes Care Inc. | Analyte Monitoring Device and Methods of Use |
US20100274107A1 (en) * | 2008-03-28 | 2010-10-28 | Dexcom, Inc. | Polymer membranes for continuous analyte sensors |
US20100280341A1 (en) * | 2008-03-28 | 2010-11-04 | Dexcom, Inc. | Polymer membranes for continuous analyte sensors |
US8920319B2 (en) | 2005-11-01 | 2014-12-30 | Abbott Diabetes Care Inc. | Analyte monitoring device and methods of use |
US9078607B2 (en) | 2005-11-01 | 2015-07-14 | Abbott Diabetes Care Inc. | Analyte monitoring device and methods of use |
US20160088428A1 (en) * | 2011-04-08 | 2016-03-24 | Dexcom, Inc. | Systems and methods for processing and transmitting sensor data |
US9501272B2 (en) | 2010-05-24 | 2016-11-22 | Abbott Diabetes Care Inc. | Systems and methods for updating a medical device |
WO2017011346A1 (en) | 2015-07-10 | 2017-01-19 | Abbott Diabetes Care Inc. | System, device and method of dynamic glucose profile response to physiological parameters |
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US20160151006A1 (en) | 2016-06-02 |
US9320462B2 (en) | 2016-04-26 |
US10463288B2 (en) | 2019-11-05 |
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US20200129098A1 (en) | 2020-04-30 |
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